PremierOne Plus MSO (POPMSO) is a management service organization serving the needs of providers in a managed care setting. PremierOne Plus MSO provides you with the resources and opportunity to build a rewarding career in an environment that support your success.
Description
Responsible for data entering, gathering, and primary source verification of healthcare practitioner information, including in-depth, detailed, or challenging research of information. Primary methods of researching information include internet, phone, fax, e-mail, and letters.
Essential Functions
- Perform primary (e.g., hospitals, licensing boards, etc.) and secondary source verification of perspective providers' credentials with special emphasis on provider issues relating to malpractice claims, privileging, criminal concerns, license anomalies, and discrepancies in education.
- Responsible for gathering and verifying physician information, compiling required documents, researching necessary information, and verifying medical licenses.
- Compiles documents, researches, and verifies provider backgrounds by contacting hospitals, licensing boards, medical schools, etc.
- Contacts or interviews provider peer references over the phone about the providers clinical performance skills.
- Create monthly credentialing meeting minutes.
- Assist the department with regular health plan audits
- Performs other duties as assigned.
Qualifications
- Associate's degree is required. A combination of education and experience will be considered
- A minimum of 1 year of credentialing or equivalent work experience is required
- Have clear and concise phone an verbal communication skills
- Ability to write legibly
- Demonstrate effective written communication skills
- Have strong computer, typing, and data entry skills: includes MS Word, Excel, and web-based application, internet, and database programs
- Detail oriented with ability to recognize vital information from verification documents
- Possess proof-reading skills sufficient for auditing documents
- Ability to prioritize well and meet overlapping deadlines
- Demonstrates problem-solving, critical thinking, and deductive reasoning skills
- Ability to consistently maintain quality and production expectations
Job Type: Full-time
Pay: From $23.00 per hour
Expected hours: 40 per week
Benefits:
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Schedule:
- Day shift
- Monday to Friday
Application Question(s):
- How many years of credentialing experience do you have?
- How many years of auditing experience do you have?
Ability to Commute:
- Buena Park, CA (Required)
Ability to Relocate:
- Buena Park, CA: Relocate before starting work (Required)
Work Location: In person